Search Results for: stop-loss

Restraining Balance Billing by Air Ambulance Providers: CHIR Keeps Up with Federal Advisory Committee and Regulatory Actions

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…by the Secretary of Transportation to inform the department’s strategy for oversight of air ambulance providers, as well as guidance concerning unfair and deceptive provider practices. The committee’s work may not stop there, though. The multi-stakeholder membership may also serve as a sounding board for implementation issues and the new law’s effects on networks, contract negotiations, access, and costs.  …

The Impact of the COVID-19 Pandemic and Recent Federal Policy on Small Business Health Insurance

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…non-ACA compliant coverage types including self-funding with a stop loss policy, group captives, professional employer associations and association health plans. The availability of these types of coverage options varies greatly by state, and is leading to concerns about adverse selection in the small group market. Many small employers remain reluctant to shift their employees to the individual market because of…

If You Lost Your Job, You May be Newly Eligible for a Lower Cost Health Plan

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The American Rescue Plan Act (ARP) expanded access to affordable health insurance coverage in a variety of ways. Starting July 1, consumers who faced a job loss this year can return to their marketplace application and find themselves eligible for health plans with a $0 premium and lower out of pocket costs for the remainder of 2021. This blog post…

Third Time’s Not the Charm: Connecticut’s Public Option Bill Fails Once Again

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…state employee plan to mitigate financial risk to the state by purchasing stop-loss insurance on behalf of the unions and small and nonprofit employers and establish a “risk fund,” financed by assessments on these entities to pay any claims that exceed the premiums collected. Allowed plan designs and benefit coverage levels for unions and small and nonprofit employers participating in…

Figuring out if COBRA Coverage is Right for You

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…applies to private-sector employers with 20 or more employees and state and local government employers. Small employers with 19 or fewer employees are not subject to this federal law but might be subject to similar state laws, sometimes referred to as “mini-COBRA” laws in 40 states and the District of Columbia. Qualifying events include job loss (for reasons other than…

The No Surprises Act and Preemption of State Balance Billing Protections

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…in other areas will preempt the state law unless the state conforms to the federal standard. A new fact sheet from CHIR experts summarizes our current understanding of this preemption framework and highlights considerations for state policymakers and federal regulators. For more on state and federal protections against surprise out-of-network medical billing, visit our one-stop-shop website on balance billing issues….

American Rescue Plan Act Will Strengthen Public and Private Health Insurance

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By Edwin Park* and Sabrina Corlette The House and Senate have passed the American Rescue Plan and the President plans to sign it today, bringing critical relief to America’s families. In addition to providing relief to unemployed workers, pulling millions of children and families out of poverty and helping school districts address learning loss, the COVID-19 relief legislation will strengthen…

Removing Roadblocks: Special Enrollment Period Data Show Increase in Marketplace Signups

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When the COVID-19 pandemic struck last year, the Affordable Care Act (ACA) acted as a critical safety net. As millions faced job and income loss in the face of a growing threat of infection and disease, Medicaid, expanded under the ACA in most states, and the law’s health insurance marketplaces provided coverage and financial assistance. Notably, states sprang into action…

Are the Good Times Over for Health Insurers?

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…did in 2019, several major health insurers reported reduced profits or even losses in the fourth quarter of 2020. Humana posted a $274 million loss, a record for the insurer. Centene reported a $12 million loss in its fourth quarter and subsequently announced it will cut 3,000 employees from its staff. Other insurers including Aetna and UnitedHealth had a decrease…

An Opportunity to Protect Consumers and Ensure a Level Playing Field: Reversing Trump-era Rules on Association Health Plans

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…Further, the Court concluded that Congress did not intend for self-employed individuals with no employees to be considered “employers” under ERISA. The Trump administration appealed that ruling, and the case has been pending for over a year. The Biden Administration can Foster Stability for the Small-group Market To protect consumers, small businesses, and providers (who often face significant financial losses…

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.